老年与中青年自发性气胸临床特征对比分析

A comparative study on cases of spontaneous pneumothorax between young or middle-aged and elderly people

目的探讨老年人、中青年人自发性气胸的临床特征,提高诊治水平。方法对2003年1月至2007年12月期间在我院就诊的321例自发性气胸患者分成老年组和中青年组,从发病季节、气胸部位和类型、基础疾病、症状、治疗方法与病程等方面进行比较分析。结果老年组患者自发性气胸在发病季节、基础疾病、临床表现、治疗方法选择、病程等方面与中青年组有显著差异。结论老年人自发性气胸在冬、春季多发,多伴有慢性阻塞性肺疾病(COPD)等基础疾病,以呼吸困难为主要症状,病情重,一般采取胸腔闭式引流治疗,病程长;中青年组自发性气胸以夏季多发,基础疾病较少,胸痛明显,治疗多采用胸腔抽气或闭式引流,病程相对较短。

Objective To investigate the clinical characteristics of spontaneous pneumothorax in young or middle - aged people and elderly people so as to raise the level of its diagnosis and treatment. Methods A total of 321 cases of spontaneous pneumotharax from this hospital were divided into young or middle - aged group （ n = 233 ） and elderly group（ n = 88 ） from January, 2003 to December, 2007. A comparative analysis was performed between these two groups in terms of onset season, diseased region, pneumatothorax types , basic diseases, subjective symptoms, therapeutic methods and course of disease. Results There were considerable differences in onset season, basic diseases, clinical manifestations and thexapeutic method for spontaneous pneumothorax and course of disease between these two groups. Conclusion Spontaneous pneumothorax in elders occurred predominantly in winter and spring, accompanied with basic diseases such as chronic obstructive pulmonary disease （COPD）, and it was characterized by severe condition and dyspnea as a major symptom. Thus intercostal tube insertion for closed drainage is usually administered for them. The disease has slighdy long duration. By comparison, spontaneous pneumothorax of young or middle - aged people often occurred in summer, seldom accompanied with basic diseases and it was characterized by chest pain as a major symptom. The treatment was mainly needle aspiration or pleural drainage. In addition, they had shorter course of disease than that of patients in elderly group.